For Immediate Release
Office of the Press Secretary
Contact: 202-282-8010

Secretary Napolitano: Good afternoon. This is the second daily briefing, and we will do these on a regular basis as we work our way through these—the swine flu issue, what is happening at the governmental level, and what is happening around the world.

First, I would like to inform you that today both the CDC [Centers for Disease Control] and the State Department will be issuing travel alerts related to swine flu and related to travel to Mexico. What those alerts mean is that they encourage individuals to avoid any non-essential travel to Mexico for the time being.

You may ask, how long will the alerts be operative? And the answer is, we don't know, because obviously it's related to how much swine flu is being detected. Those alerts are in the process—I think CDC has already posted theirs, and State Department is in the process of posting those travel alerts.

Secondly, as President Obama said this morning, swine flu is a cause for concern but not a cause for alarm. We are simply in preparation mode. We do not yet know how widespread this flu will be within the United States, so we continue to move aggressively to prepare.

I spoke this afternoon with Mexico's Ambassador to the United States, so that our governments are moving in tandem, and I will be speaking later on with my counterpart in Canada. We really have a tri-national approach to the flu issues.

As I said yesterday, I issued a public health emergency declaration. That permitted today the—an emergency authorization that allows the FDA [U.S. Food and Drug Administration] to proceed to permit things like Tamiflu to be used for populations that they otherwise wouldn't be used for—in this case, for example, very, very young children.

The Department of Homeland Security is conducting conference calls with state public health and homeland security officials on a daily basis to discuss developments related to swine flu, and I've reached out to the governors of each of the states where a confirmed case has arisen.

As I said yesterday, we are in the process of activating our national stockpile of antiviral drugs. The priority is placed on states that have been affected, as well as states along the border. And antivirals already are on the way to some of these states. All states will have access to the national stockpile and full deployment is expected by the third of May.

The Department of Homeland Security continues to direct people entering the United States from Mexico who appear to be sick to the CDC or to local health officials to be evaluated. In addition, the Travelers Health Alert notices are being posted at ticket counters and gates within the airports, and at the land ports there's a tear sheet that is being handed out to travelers.

We are reaching out to the private sector to make sure that they are preparing, and to inform them of the latest actions we are taking. It's important that they be thinking ahead about what they would do should this erupt into a full-fledged pandemic, which it has not yet, by the way.

And finally, we are taking precautionary measures with respect to the health of our own workforce. We have pre-positioned antivirals for all the nine Border Patrol sectors and for our Coast Guard sectors to ensure they remain at full strength. We've provided guidance to all employees on how to use antivirals.

We continue to stress, the CDC continues to stress, the Department of Health and Human Services continues to stress that common sense will go a long way here to mitigate the impact of any flu. Common sense means washing hands, staying home from work or school if you feel sick, covering your mouth if you cough or sneeze. These are straightforward and simple measures, but they can materially improve our chances of avoiding a full-fledged pandemic.

Everybody has a role to play here. It's our function to make sure that what the government is doing is coordinated, that we are thinking in advance of the problem. But again, government cannot do this alone; we all have an important part to play.

So with that, alerts are posted—information is available, by the way, for people who are interested—the CDC website is a very, very good Web site: cdc.gov/swineflu is the exact address. In addition, www.state.gov, and www.travel.state.gov, the two State Department Web sites, also have information. And of course, the Department of Homeland Security's Webs ite has information and will click you over into other department websites as well.

With that, John, Pat, I'll be happy to take some questions.

Question: [Indaudible]

Secretary Napolitano: Don't know yet. We're just in the beginning process of trying to collect that kind of information. But again, what I've been saying is, we'll provide you with information on a daily basis as we work our way through this.

Question: How does that work? Someone comes to the border inspection person and is coughing or displays some sort of symptom, is there a health professional right there to see them, and who are those folks?

Secretary Napolitano: It depends on which port you're entering at, you know, because there are different sizes, different locales, and all the rest. Generally speaking, they're referred to or put in another room. I don't want to use the word "quarantine," because technically it's not a quarantine, but they're put in a separate room, and they're either questioned by a Customs Border Protection officer who has some training in this, or in the bigger ports either a public health official who is onsite, or they call the local public health authority to have some people brought over, and they'll question them.

And then if it's ascertained that they may indeed have the flu, they'll make a decision about whether they can go ahead and enter the country and go to a place to get taken care of or whether they need to go back home.

Question: But it doesn't appear to be that the—that just large numbers of people are being diverted into this secondary inspection?

Secretary Napolitano: Not that I've heard of today. Again, this is a changing scene, and so that that may change, but as of today I've not heard of that.

Question: How has Mexico done in responding to this?

Secretary Napolitano: Well, Mexico has had a much more acute problem to solve. You know the steps that have been taken in Mexico City, for example, with respect to closing down the schools, shutting off places where people would gather, issuing masks and the like.

So they are taking every public health precaution one can identify with respect to this kind of an outbreak. We have people down there now, teams from the CDC. One of the things that we are assisting on is laboratory capacity for running diagnostic samples, but also collecting good data, because it will help us for our planning if we can see how widespread this really is in Mexico.

Question: Can you tell us, Madam Secretary, and perhaps Mr. Brennan [Assistant to the President for Counterterrorism and Homeland Security John Brennan], as well, a little bit about when the United States government first became sort of fully aware of these events in Mexico and how you began to come up with your response, one. And then what about today brought on the travel alert? What changed today to bring on the travel alert?

Mr. Brennan: The first instances of the influenza down in Mexico were at the end of last week. In terms of confirmation, it was like Thursday or Friday of last week. So the Mexican health authorities knew they had a health issue, and therefore they sent the samples to both the Canadian labs as well as to the CDC. And so the confirmation that it was swine flu was last week.

But to date, at least from my perspective, the Mexican authorities have been exceptionally cooperative and forthcoming. Both Secretary Napolitano and I have spoken to the Mexican ambassador, and I think that there's been a very strong cooperation.

Secretary Napolitano: Yes, and Ginger, by Friday we were beginning to assemble the information, inform the inter-agency team that would need to work this issue over the weekend. And under HSPD-5 [Homeland Security Presidential Directive 5], I was designated as the principal federal official, and we began—that whole process was well underway as we worked throughout the weekend.

Question: [Inaudible] …Friday, and it was Mexican authorities who first notified the United States?

Mr. Brennan: Through the health—

Secretary Napolitano: There were health issues.

Mr. Brennan: Through the health professionals that were cooperating, both U.S. and Mexican health officials.

Secretary Napolitano: I think that, in part, is just because the data—as the data becomes more robust, then better decisions can be made about what actually needs to happen.

Question: What kind of guidance are you giving state and local governments in terms of what they should do if they have cases of the flu now? For instance, are you suggesting if it's in a school they close down the schools?

Secretary Napolitano: The CDC has issued community mitigation guidance to communities, and we can give you an actual copy of that.

Question: Madam Secretary, have you issued any notes or information to local law enforcement related to this?

Secretary Napolitano: We are in touch with local law enforcement and we're in touch with the fusion centers in the various states. They have access to all the material, for example, that's posted on the CDC website, our website and the like for whatever use they care to make.

Question: Would the administration be making any kind of additional budget request to Congress to cover actions taken, actions that may be taken, or do the current budgets cover this kind of situation?

Secretary Napolitano: I don't think any decision has been made on that yet.

Question: Can you talk about the lack of personnel across both HHS [U.S. Department of Health and Human Services] and DHS—I think the figures for DHS are two confirmed in place, six announced or nominated, 13 unnamed including the Assistant Secretary for Health, the TSA [U.S. Transportation Security Administration] and CBP [U.S. Customs and Border Protection] directors, FEMA [Federal Emergency Management Agency] not being confirmed, and principal federal officers and chief coordinating officers within FEMA for pandemic? Would it be helpful to have more bodies on board? Is that a concern?

And on the pandemic plan, has it been triggered, how closely are you following it, how useful a playbook is it?

Secretary Napolitano: With respect to presidential appointees, confirmees, those roles are all being filled by career civil servants who have a great deal of experience. And as far as I'm concerned, the process, the work has been moving very smoothly and with great efficiencies. So I think we're moving right along in that sense.

With respect to the pandemic playbook, the World Health Organization has us at level three, which is basically preparatory to pandemic. Today they are meeting with respect to whether that level should be raised. Level six is actual pandemic. And so we're keying off of that.

And even if they raise the level today, our preparations now are as if it had already been raised. So we are proceeding as if we are preparatory to a full pandemic. We don't know that a pandemic actually will occur, but because we want to make sure that we have equipment where it needs to be, people where they need to be, and most important, information shared at all levels, we've already organized as if this were.

Question: I think if at the next level, at level four, that there are possible—in the plan, in the pandemic plan it's possible that the border could be—parts of the border could be closed down or increased border surveillance of people coming across. Is that something that's been discussed at this time?

Secretary Napolitano: Well, as I said yesterday, we're already doing passive surveillance at the border. And with respect to closing the border, again, you would close the border if you thought you could contain disease, the spread of disease. But the disease already is in a number of states within the United States, so the containment issue doesn't really play out. This particular flu, you can actually have it for a couple of days before you show any symptoms, and so even if—people could be coming through now, even under passive surveillance, who actually have the flu. So that's a very difficult judgment to make.

Question: Other than notices being posted at gates at the airport, specifically, what else is TSA doing? Are passengers being questioned—incoming flights into this country?

Secretary Napolitano: Well, again, if they're coming from international travel, they have to go through CBP, and CBP is doing the passive surveillance if passengers appear sick, and they are also asking—able to ask questions, particularly on flights that originate in Mexico.

And as I said before, they're giving out what's called a "tear sheet," which is—we can give you a copy of that. It actually tells you what to look for and what to do if you think you're getting ill. And that information is being posted in the airports and at the gates.

Question: Are there any quarantine centers at airports if it does become a pandemic?

Secretary Napolitano: My understanding is that we have 19 airports that have quarantine available. That would cover about 85 percent of air travelers. But we haven't activated that need yet, and we may not need to. We don't know. We have identified where they are, what we would need to do in case the facts warrant it later on.

Question: You say that it takes about three to four days for the symptoms to show up, so people could come in by air and not know that they have it, because the symptoms haven't shown up, and they'll be able to walk right in, right? I mean, is there any contingency plans for dealing with that? How would you deal with something like that?

Secretary Napolitano: Well, if people are sick, and if you have the flu, you believe you have the flu, you have a fever, you have a heavy cough, we're asking people—

Question: —might not know for three or four days—

Secretary Napolitano: —we're asking people, don't go to school, don't go to work, don't go to a place where you can infect other people. I mean, the normal tendency is—you know, we have a lot of type-A personalities, and people want to go—keep working, and we're saying, don't do that if you believe realistically that you have the flu. If you don't know, but you show some of the symptoms, contact your doctor.

And going to your question, what you're saying is, people could still be coming in the country because they're asymptomatic, may have the flu, and that is true. But again, given the number of cases and what's actually appearing and the like, we believe at this level the appropriate precautions have been taken.